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renal

Author

9 Posts

drkhuls
Forum Newbie

Topics: 4
Posts: 20

11/20/07 - 09:24 AM

elderly pt. with gross total painless hematuria , with normal renal functions test . how u gonna proceed as next step?
can anybody explain use of IVP
ultrasonography
ct scan
which amongst them is used next!!!!!!!!!!!!!!!!!!!

me007
Forum Guru

Topics: 72
Posts: 803

11/20/07 - 12:09 PM

Mnemonic for Hematuria DDx=
T-SHIRTTT:
T umor, e.g. bladder CA
S tone (nephrolithiasis)
H emophilia
I nfection (UTI)
R enal, e.g. GN
T rauma
T hrombocytopenia
T B

Diagnostic approach depends on question. Can't say exactly with only "gross hematuria - normal renal functions tests"

tamerbashir
Forum Elite

Topics: 20
Posts: 284

11/20/07 - 06:52 PM

good m2007

but i think we can start by u/s for evaluate renal patient

drduck
Forum Guru

Topics: 82
Posts: 529

11/20/07 - 09:30 PM

elderly patient with gross and painless haematuria............think of Ca...bladder, unless proved otherwise.

suspecting that.....i go for CT scan...more sensitive than USG,

but still firstline investigation shud be USG..

waiting for the answer.

me007
Forum Guru

Topics: 72
Posts: 803

11/22/07 - 09:00 PM

http://www.postgradmed.com/issues/2005/10_05/sonp...

brutus25
Forum Junior

Topics: 13
Posts: 62

11/23/07 - 02:10 AM

1st - CT noncontrast ( look for stones )
2nd - CT contrast ( malignacy ... )
3rd - Urologic procedures - IVP ...

me007
Forum Guru

Topics: 72
Posts: 803

11/23/07 - 02:44 PM

brutus25 wrote:
1st - CT noncontrast ( look for stones )
2nd - CT contrast ( malignacy ... )
3rd - Urologic procedures - IVP ...

what is the source of this information?

Standard sequence is IVP first and cystoscopy next for bladder cancer, according to KLN

brutus25
Forum Junior

Topics: 13
Posts: 62

11/25/07 - 02:24 AM

http://www.maaua.org/abstracts/2005/p13.cgi
It`s troubling me also because I was dead on IVP esp if the pt has normal renal function
I`ll keep looking

chemamr
Moderator and PGY1
avatar

Topics: 703
Posts: 4,441

11/25/07 - 06:23 AM

first, the question itself is not very helpful. I guess you already have a U/A confirming the blood in the urine (but maybe crystals, casts, proteins, bacteria could be helpful for the Dx and next step).

Despite the large number of studies that examined this issue, evidence-based guidelines do not exist to help decide the optimal imaging modality. However with an old patient you could go for: U/S or helical CT scan.

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